anaemias

Question 1

what is sickle-cell anaemia?

Answer 1

-when someone has deformed, less flexible red blood cells

Question 2

what is sickle cell crisis?

Answer 2

-can lead to restricted blood supply to the organs

Question 3

what is the management for sickle cell crisis?

Answer 3

-hospitalisation= fluid replacement, analgesics, treat infections

Question 4

what type of complications can come from sickle-cell crisis?

Answer 4

-anemia
-leg ulcers
-renal failure
-susceptibility to infections

Question 5

what is haemolytic anaemia?

Answer 5

-break down of red blood cells

Question 6

what is the management for haemolytic anemia?

Answer 6

increase folate (folic acid supplemention

Question 7

how to prevent sickle cell crisis? medication

Answer 7

hydroxycaramide
-reduces frequency of painful crisis and reduces transfusion requirements

Question 8

what is G6PD deficiency? (glucose-6-phosphate dehydrogenase)

Answer 8

a type of deficiency

Question 9

what types of people are more prone to what is G6PD deficiency?

Answer 9

-males than women
-African and Asian countires

Question 10

are people who are G6PD deficiency susceptible to haemolytic anaemia?

Answer 10

-yes
-more acute haemolytic anaemia

Question 11

what drugs definitely increase the risk of haemolytic in most who is G6PD deficiency people?

Answer 11

-dapsone and other sulfones
-fluroroquinolones
-nitrofurantoin
-quinolones

Question 12

what drugs have a possible increased risk of haemolytic in most who is G6PD deficiency people?

Answer 12

-aspirin
-chloroquine
-menadione
-quinine
-sulfonylureas

Question 13

when can you start treatment for iron defieicney?

Answer 13

when you can show they are iron deficient through blood tests, signs and symptoms what are so

Question 14

what are the signs and symptoms of iron deficiency?

Answer 14

-tiredness
-shortness of breath
-palpitations
pale skin

Question 15

what should be ruled out before starting iron deficiency treatment?

Answer 15

-gastruc erosion
-gastro-intestinal cancer

Question 16

when is prophylaxis iron used mainly? in which cases?

Answer 16

-malabsorption
-menorrhagia
-pregnancy
-after subtotal or total gastrectomy
-in haemmodialysis patients
-in the management of low birth-weight infants such as preterm neonates

Question 17

what are the different types of irons?

Answer 17

-ferrous fumarate
-ferrous gluconate
-ferrous sulfate
ferrous sulfate (dried)

Question 18

what is the normal iron and some given?

Answer 18

-normally the dried sulphate can be MR preps too (reduces absorption)
-daily elemental iron dose of 100 to 200mg (dose within the tablet)

Question 19

what are some side effects of iron tablets?

Answer 19

-constipation or diarrhoea
-black tarry stools- more common

Question 20

when should you stop taking iron?

Answer 20

C.diffe can cause diarrhoea

Question 21

what can irons tablets be taken with to help with absorption?

Answer 21

with vitamin c and best before food but can help reduce side effects if taken after food

Question 22

when should you stop taking iron due to good haemoglobin levels?

Answer 22

can stop when Hb in range but then need to continue for 3 more months

Question 23

what can be used to treat iron toxicity?

Answer 23

desferrioxamine

Question 24

what are the different parenteral iron?

Answer 24

-iron dextran
iron sucrose
-iron carboxymaltose
-ferric derisomaltose

Question 25

when is parenteral iron used?

Answer 25

oral therapy is not tolerated
-chemotherapy induced anaemia
-chronic renal failure who are receiving haeomdialysis

Question 26

what’s the MHRA warning regarding parental iron? what should be done

Answer 26

-serious hypersensitivity reactions with IV iron
-after every iv treatment patient should be monitored for hypersensitivity for at least 30mins

Question 27

what is megoblastic anaemia due to?

Answer 27

-vit b12 or folate deficiency
first cause should be to establish cause

Question 28

what to do if it is an emergency and you cant establish what the cause of megaloblastic anaemia is?

Answer 28

-give both
-don’t give folic acid alone if undiagnosed may cause neuropathy

Question 29

if the cause of megaloblastic anaemia is caused by B12 deficiency what to do?

Answer 29

-give hydroxocobalamin (vit b12) at intervals of up to 3 months
-treatment initiated with frequent IM injections to replenish storers then maintenance

Question 30

if the cause of megaloblastic anaemia is caused by folate deficiency?

Answer 30

-due to poor nutrition , pregnancy or anti epileptic drugs
-daily folic acid supplements for 4 months

Question 31

what is the dosing for folic acid?

Answer 31

-regular pregnancy: 400mcg daily from before conception til week 12 of pregnancy -OTC
-risk of NEUROTUBE DEFECTS_) NTDS: 5mg daily from conception till week 12 of pregnancy- POM

Question 32

What are the risk factors neural tube defects?

Answer 32

smoking
sickle cell anaemia
diabetes
obesity
anti-epileptics
anti-malarial